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Use of physiotherapy and alternatives by children with cerebral palsy: a population study
1Health & Social Care Research Unit, The Queen's University of Belfast, Belfast, UK. j.parkes@qub.ac.uk
Insights
Families of children with moderate to severe cerebral palsy (CP) use many services, with most receiving physiotherapy. However, some opt for alternative therapies, and many parents desire more physiotherapy, indicating service gaps.
Area of Science:
- Pediatric Rehabilitation
- Neurology
- Public Health
Background:
- Cerebral palsy (CP) is a common childhood motor disability.
- Understanding service utilization is crucial for optimizing care for children with CP.
Purpose of the Study:
- To describe the utilization of physiotherapy and alternative therapies in children with moderate to severe CP.
- To identify patterns and preferences in service use among this population.
Main Methods:
- A descriptive cross-sectional survey was conducted.
- Data were collected from 212 parents and their children (aged 4-14 years) with moderate to severe CP.
- Questionnaires were used to gather information on service use, validated by paediatric physiotherapists.
Main Results:
- High service utilization was observed, with families accessing approximately seven services bi-annually.
- 96% of children received physiotherapy during school terms, often multiple times weekly.
- 28% of families utilized private alternatives to NHS services, including conductive education and private physiotherapy.
- Children with more severe CP and those in special education were intensive physiotherapy users.
- 74% of parents expressed a desire for increased physiotherapy provision.
Conclusions:
- Continued high demand for physiotherapy services is anticipated due to stable CP prevalence and parental interest.
- Significant gaps and areas for quality improvement in current physiotherapy services for children with CP have been identified.
- Parental desire for more physiotherapy suggests unmet needs within the existing service framework.
Objectives:
To describe the use of physiotherapy services and alternative therapies by a population of children with moderate to severe cerebral palsy (CP).
Design:
Descriptive cross-sectional survey.
Subjects:
A total of 212 parents of children aged 4-14 years with moderate to severe CP were identified from the Northern Ireland Cerebral Palsy Register (NICPR) and a random subsample of their paediatric physiotherapists.
Main Measures:
A standardized description of motor impairment or assessment form; a postal questionnaire to parents and paediatric physiotherapists (to validate parents' reports of service use). RESPONSE RATES: In total, 85% of parent questionnaires were returned and 100% of paediatric physiotherapists responded.
Results:
Service use among families was high; on average the families had contact with approximately seven services in a 6-month time interval. The overwhelming majority of children (96%) received physiotherapy during the school term and most (59%) received treatment at least twice a week for 30 min; 43% of children had their physiotherapy discontinued over the summer holidays. Over one-quarter (28%) of families had opted out of the NHS and bought alternatives like conductive education (21%) or private forms of conventional physiotherapy (16%). Children with more severe forms of CP, in special education, particularly at schools for physical disability, were high-intensity users of the physiotherapy service. Despite this, 74% of parents wanted more physiotherapy for their child.
Conclusions And Implications:
The demand for physiotherapy services is likely to continue given the relatively stable prevalence rate of CP, the proportion of children with disabling CP and the level of parent interest in the service. A number of quality aspects and gaps in the service have been identified.